Illinois Nursing
License Exam:
Practice Questions
with Rationales
Section 1: Safe and Effective Care Environment –
Management of Care
1. A nurse is preparing to administer morning medications. Which action should
the nurse take FIRST?
A. Check the client's blood pressure
B. Review the medication administration record (MAR)
C. Verify the client's identity using two identifiers
D. Explain the purpose of each medication
Correct Answer: C
Rationale: Patient safety begins with identifying the correct client using two identifiers
(name and date of birth, or name and medical record number). This must occur before
any medication administration per The Joint Commission National Patient Safety Goals.
Reviewing the MAR and explaining medications are important but secondary to
confirming the correct client.
,2. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which tasks
are appropriate to delegate? Select all that apply.
A. Obtaining vital signs on a stable postoperative client
B. Performing a focused respiratory assessment
C. Assisting a client with feeding who has stable swallowing ability
D. Providing discharge teaching
E. Recording intake and output
F. Transporting a stable client to radiology
Correct Answer: A, C, E, F
Rationale: UAP may perform routine, non-invasive tasks such as vital signs, feeding
assistance for stable clients, intake/output measurement, and transportation.
Assessment, teaching, and evaluation require nursing judgment and cannot be
delegated according to NCSBN guidelines.
3. A charge nurse is making assignments for the medical-surgical unit. Which
client should be assigned to the most experienced registered nurse?
A. A client with newly diagnosed type 2 diabetes who requires diet teaching
B. A client with cirrhosis whose blood pressure has dropped from 120/80 to 90/60
mmHg over the past hour
C. A client with pneumonia who is being discharged this afternoon
D. A client with a fractured femur in balanced skeletal traction
Correct Answer: B
Rationale: The client with cirrhosis and a significant blood pressure drop is at risk for
hypovolemic shock from possible variceal bleeding, requiring rapid assessment and
intervention by the most experienced nurse. This client has the highest acuity and
instability.
4. A nurse observes a coworker diverting a narcotic pain medication for personal
use. What is the priority action?
,A. Confront the coworker directly about the behavior
B. Document the observation in the client's medical record
C. Report the behavior to the nurse manager or supervisor immediately
D. Call the local police department
Correct Answer: C
Rationale: The nurse has a legal and ethical duty to report suspected impaired practice
to a supervisor. This protects client safety and allows the employer to intervene
appropriately. Documentation should not occur in the client's chart, as this violates
confidentiality.
5. A nurse is reviewing a client's advance directive. The client has a living will
stating "no heroic measures." The surgeon asks the nurse to witness the client
signing a consent form for a high-risk procedure. What is the nurse's priority
action?
A. Witness the consent as requested
B. Verify the client understands the procedure and its risks
C. Refuse to witness because of the living will
D. Contact the ethics committee immediately
Correct Answer: B
Rationale: The nurse's role in informed consent is to verify that the client understands
the procedure, risks, benefits, and alternatives, and that consent is voluntary. A living will
does not prohibit surgery; it guides end-of-life care.
6. A nurse manager is developing a staffing plan for a unit with a high volume of
chemotherapy administration. Which factor is most important in determining
appropriate staffing?
A. Number of beds on the unit
B. Acuity level of clients and required nursing skills
C. Years of experience of the nursing staff
D. Availability of assistive personnel
, Correct Answer: B
Rationale: Staffing decisions must be based on client acuity and the skill mix required.
Chemotherapy administration requires specific competencies. Bed count alone is
insufficient. Experience level is relevant but secondary to matching skills to client needs.
7. A nurse is caring for a client who is 1 day postoperative following a total hip
replacement and reports pain rated 4/10. Which client should the nurse assess
first?
A. The client with hip pain rated 4/10
B. A client who has type 2 diabetes and a fasting glucose of 142 mg/dL
C. A client who has heart failure and reports increasing dyspnea over the past 2
hours
D. A client who has a new colostomy and requests assistance with appliance change
Correct Answer: C
Rationale: Increasing dyspnea in a heart failure client may indicate worsening fluid
overload, pulmonary edema, or cardiac decompensation. The ABC prioritization
framework directs the nurse to address breathing difficulties first.
8. A nurse is teaching a client about advance directives. Which statement by the
client indicates understanding?
A. "A living will tells my family what treatments I want."
B. "A durable power of attorney for healthcare allows someone to make decisions
for me if I cannot."
C. "Advance directives are only for elderly clients."
D. "Once I sign an advance directive, I can never change it."
Correct Answer: B
Rationale: A durable power of attorney for healthcare designates a healthcare proxy to
make decisions when the client is unable. Living wills specify treatments desired.
Advance directives can be changed at any time and are appropriate for all adults.
License Exam:
Practice Questions
with Rationales
Section 1: Safe and Effective Care Environment –
Management of Care
1. A nurse is preparing to administer morning medications. Which action should
the nurse take FIRST?
A. Check the client's blood pressure
B. Review the medication administration record (MAR)
C. Verify the client's identity using two identifiers
D. Explain the purpose of each medication
Correct Answer: C
Rationale: Patient safety begins with identifying the correct client using two identifiers
(name and date of birth, or name and medical record number). This must occur before
any medication administration per The Joint Commission National Patient Safety Goals.
Reviewing the MAR and explaining medications are important but secondary to
confirming the correct client.
,2. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which tasks
are appropriate to delegate? Select all that apply.
A. Obtaining vital signs on a stable postoperative client
B. Performing a focused respiratory assessment
C. Assisting a client with feeding who has stable swallowing ability
D. Providing discharge teaching
E. Recording intake and output
F. Transporting a stable client to radiology
Correct Answer: A, C, E, F
Rationale: UAP may perform routine, non-invasive tasks such as vital signs, feeding
assistance for stable clients, intake/output measurement, and transportation.
Assessment, teaching, and evaluation require nursing judgment and cannot be
delegated according to NCSBN guidelines.
3. A charge nurse is making assignments for the medical-surgical unit. Which
client should be assigned to the most experienced registered nurse?
A. A client with newly diagnosed type 2 diabetes who requires diet teaching
B. A client with cirrhosis whose blood pressure has dropped from 120/80 to 90/60
mmHg over the past hour
C. A client with pneumonia who is being discharged this afternoon
D. A client with a fractured femur in balanced skeletal traction
Correct Answer: B
Rationale: The client with cirrhosis and a significant blood pressure drop is at risk for
hypovolemic shock from possible variceal bleeding, requiring rapid assessment and
intervention by the most experienced nurse. This client has the highest acuity and
instability.
4. A nurse observes a coworker diverting a narcotic pain medication for personal
use. What is the priority action?
,A. Confront the coworker directly about the behavior
B. Document the observation in the client's medical record
C. Report the behavior to the nurse manager or supervisor immediately
D. Call the local police department
Correct Answer: C
Rationale: The nurse has a legal and ethical duty to report suspected impaired practice
to a supervisor. This protects client safety and allows the employer to intervene
appropriately. Documentation should not occur in the client's chart, as this violates
confidentiality.
5. A nurse is reviewing a client's advance directive. The client has a living will
stating "no heroic measures." The surgeon asks the nurse to witness the client
signing a consent form for a high-risk procedure. What is the nurse's priority
action?
A. Witness the consent as requested
B. Verify the client understands the procedure and its risks
C. Refuse to witness because of the living will
D. Contact the ethics committee immediately
Correct Answer: B
Rationale: The nurse's role in informed consent is to verify that the client understands
the procedure, risks, benefits, and alternatives, and that consent is voluntary. A living will
does not prohibit surgery; it guides end-of-life care.
6. A nurse manager is developing a staffing plan for a unit with a high volume of
chemotherapy administration. Which factor is most important in determining
appropriate staffing?
A. Number of beds on the unit
B. Acuity level of clients and required nursing skills
C. Years of experience of the nursing staff
D. Availability of assistive personnel
, Correct Answer: B
Rationale: Staffing decisions must be based on client acuity and the skill mix required.
Chemotherapy administration requires specific competencies. Bed count alone is
insufficient. Experience level is relevant but secondary to matching skills to client needs.
7. A nurse is caring for a client who is 1 day postoperative following a total hip
replacement and reports pain rated 4/10. Which client should the nurse assess
first?
A. The client with hip pain rated 4/10
B. A client who has type 2 diabetes and a fasting glucose of 142 mg/dL
C. A client who has heart failure and reports increasing dyspnea over the past 2
hours
D. A client who has a new colostomy and requests assistance with appliance change
Correct Answer: C
Rationale: Increasing dyspnea in a heart failure client may indicate worsening fluid
overload, pulmonary edema, or cardiac decompensation. The ABC prioritization
framework directs the nurse to address breathing difficulties first.
8. A nurse is teaching a client about advance directives. Which statement by the
client indicates understanding?
A. "A living will tells my family what treatments I want."
B. "A durable power of attorney for healthcare allows someone to make decisions
for me if I cannot."
C. "Advance directives are only for elderly clients."
D. "Once I sign an advance directive, I can never change it."
Correct Answer: B
Rationale: A durable power of attorney for healthcare designates a healthcare proxy to
make decisions when the client is unable. Living wills specify treatments desired.
Advance directives can be changed at any time and are appropriate for all adults.
